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我在安宁疗护病房见证的死亡

作者:admin 2020-10-29 我要评论

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快言快语的东北女性刘寅,一点也看不出快六十的样子。去年她在北京的一家医院筹建了安宁疗护病房,病房门口用中英文写着临终关怀倡导者西西里·桑德斯的一段话:“你很重要,因为你是你,即使活到最后一刻,你仍是那么重要……” 做了一辈子肿瘤科医生,刘寅见证了太多病人的离世。随着安宁疗护理念的推广,一些病人在身体“没有积极治疗价值”之后,接受着人生最后阶段的姑息治疗。刘寅说,做安宁疗护的人,需要识别他人的灵性痛苦。这项工作也可以做到和助产士一样,一个是帮人喜悦地迎来生命的奇迹,一个是帮人平静地接受生命的消失。而一个人死亡时能否平静,牵涉到家庭、社会等多方面现实。

 

刘寅在与病人和家属聊天

 

口述/刘寅  采写/吴琪  摄影/黄宇

患者何时不再需要积极治疗?

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安宁疗护工作是希望陪伴病人走好人生的最后一段路

 

congdingyishanglaishuo,tongguoyixuezhiliaowufajiejuezheigebingrendejibingwentile,caijinruguxiduizhengzhiliao。danshiwomenhenduozhongguorenshifeichangjihuitanlunsiwangde,yigebingrenxuanzeshenmetaidumianduizhiliao,henduoshihoumeiyoujingguoyujiaren、yuyishengchongfenyouxiaodegoutong,bingrenyinweiduijibinglejiedejuxianxing,duizhiliaofangandebuquedingxing,kenengshitamenzuihoudejuedingbuchengshu。shenmeyangdebingrenyinggaijinruguxizhiliaojieduan,xuyaomianduimeigejutidebingrenlaizuopanduan。congshengcunqidejiaodukan,yibanshizaishengmingdezuihou3~6geyue。

jinnianchunjieqijian,womenbingfanglaileyigehuanfeiaidelaoren。laorenshiqinghuadaxuebiyededaxuejiaoshou,kuai80suile,yieryinvfenbiezaiguowaihebeijinggongzuo,wojiaotazhanglaoshi。chuzhendeshihou,tajiubeizhenduanweixiaoxibaofeiai(guangfanqi)、shangqiangjingmaiyapo(yanmianjisizhishuizhong)、liangcexiongqiangjiye、ganzhuanyi、guzhuanyi,zhenggerenbiechuanhenyanzhong。wochafangshi,zhanglaoshifeichangbuqingyuandizaichizhiqianyishengjitakaideyituoboganjiaonang(vp16),tajianjuejujuexitongzhiliao。taweishenmebujieshouzhiliao?woyubingrenhejiashuliaoxialai,huodezheiyangjigexinxi:diyi,zhanglaoshidefurensiyushiguanai。furenzuolefangliaohehualiao,shoulehaoduodezui。dengdaozhanglaoshizijideleaizheng,taxiangqihualiaojiuyouxinliyinying。tadeshuofashi:“rangwozaodianjieshu,bierangwoshouzuijiuxing。”dier,zhanglaoshichachuaizhengshiqingkuangyijinghenyanzhong,tajuedezijibujiujiuyaolishile,duizijibingqingdepanduanfeichangbeiguan。

xiaoxibaofeiaidechucihualiaoxiaoguoyibanhuifeichanghao,zaiwokanlai,zhanglaoshidangshifangqizhiliaotaikexile。wodiyicidongyuantashishuo:“womenjinibaxiongshui(xiongqiangjiye)fangyifang,xiongqianglidadianshunbo(yizhonghanbodekangaiyaowu),xingbuxing?”tabutongyi。

guoleyigexingqi,tachivp16jiaonangqueshimeishenmeqise,woyougentagoutong。“nizheigexiaoxibaofeiaixianzaichuyudiyicizhiliaojieduan,buzhiyoudiankexi。nichuanbiezheimezhongyebushufu,woyigaishanzhengzhuangweimudelaijinizhi,zanbuyizhiliaozhongliuweimude,nishuohaobuhao?”jiezhewoyoushuo,“zhanglaoshi,womenyongyaodemudeni,zhuyaoshirangnideshentiganjueshufu。erqienikan2020niandechuntian,zheigeshijietairenaole,zanmenzhengquyiqikangewanzhengdechuntian,haobuhao?”

wogoutongleliangci,zheiweilaojiaoshoutongyile。kaolvdaohuanzhedenianling,woyonglezhengchangzhiliaoliangsanfenzhierdeyaoliang,jinliangjianshaoyaowudefuzuoyong,rangbingrenshentibunanshou。santianhoubingrenshuizhongjibenxiaoshi,dierzhouqiwomenjitayonglevp16koufujiajingmaishunbo,tadeshangqiangjingmaiyapozhengzhuanghenkuaidedaolehuanjie,xiongshuidedaokongzhi,renyebuxuyaoxiyangle,zhenggerenshufuduole。

jiezhe,zhanglaoshidehaizicongmeiguohuilaile,tadeqinggandedaojinyibuzhichi,zaijiashangshentiganshoushufule,duizhiliaobiandejijile。jiashuhewoshanglianghou,wojizhanglaoshijiayonglexindemianyizhiji。zhanglaoshiyouxiebuhaoyisididuiwoshuo:“woyaoshinengzaihuoliangsannianyetinghaode。”wogentashuo:“zhanglaoshi,ninjidewojinidechengnuoma?woxiwangnindezhengzhuangnenggougaishan,huodeshufuxie,zanmenzhengqukanyigewanzhengdechuntian,niyijingkandaole。womengongtongnulihuohaomeiyitian,haoma?”

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安宁疗护病区很注重病人的精神需求

 

无法按照自己的心愿去世

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youyitianwojiedaoyigetongxingdedianhua,shuoyouyiweizhumingxuefudelaojiaoshou,renkuaibuxingle,zaiwomenyiyuanjizhenke,mafanwoguanzhuyixia。jizhenkegenwomenlianxi,shuozheiweilaojiaoshouyijingchuyumiliuzhuangtai。wopaodaojizhenkeyikan,yiweishuairuodelaorentangzaineili,shenxiabuduandiyouxuebianchulai,kanshangqufeichangkelian。wowenta:“ninganjuezenmeyang?”laorenjiashuo:“woyaoanlesi。”zheigexianranbuxianshi。wowenta:“ninjialirenni,sheinengguannin?”pangbianzhanzheyigebaomumoyangderen,tashuolaorendelaobanyijingqushi,haizimendouzaiguowai,tazhijilaorenzuoleliangsangeyuedebaomu。wowen:“nenglianxidaoshei?”baomushuo:“laorenyougexueshengjiaozhangdaning(huaming),henduoshiqingdoushitazaibanli。”

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laorenyijingchuyuxiukezhuangtai,yushigenjudianhualilaorenhaizimendejianjueyaoqiu,yishengjilaorenshuye、zhixue,lianxixuekuzhunbeishuxue,youjilaorenchaleweiguan、daoniaoguan,jitashuyang。diertianzaoshangwochafangdeshihoulaorenqingxingguolai,laorenshuo:“nimenjiwonongzheixie,wotongyilema?doushipianzi,yiyuanyeshipianzi。”houlaiwomenlejiedao,laorenyizhibutongyizhuyuanzhiliao,zhidaoqianjitianchuxianxuebian,yinjianchibulaiyiyuan,chuyuxiukezhuangtaile。baomujijimangmangyutazaiguowaidehaizimenshipin,laorenzhengyankandaolenverdeyingxiang,yiweinverhuilaile,dayingquyiyuan。tarenweijishiqudaoyiyuan,yezhishijieshouyidianzhichizhiliao。denglaorenzaiwomenkeshiqingxingguolai,faxiannvermeihuilai,zijihaibeipochaguan,gandaofeichangqifen。

womendeshegongzhiyuanzheyizhizaipeihewomenyihurenyuanzuolinzhongbingrendeanningliaohu。zhiyuanzhejiaqichangshiyulaorenliaotian,laorentaiduhenlengdan。dengdaojiaqiyaolikaideshihou,laorenturanzhuaileyixiatadeshou,babaomuzhilechuqu,duijiaqishuo:shiqinghenfuza,wobuxiangbaniqianchejinlai。womenzheiweishegonghengandong,houlaitidaohaojici,laorendaolezheigeshihou,haizaitibierenzhexiang。jiaqihaishixiangjitatigongzhichi,yutaliaolejici。laorenshuo,tayoumingquedezhutuo,jiushixiwangananjingjingdisizaijiali,buyaorangtashouzhemo。taxiangbafangzijuanjizijisuozaidedaxue,danshizheiqianchedaojiarenliyi,hennanshixian。laorenjinianqianjiuweisiwangzuozhunbeile,bayinxingkadouqinglile。tashuotazheiyibeizipeiyangguohenduoren,chengjiuguohenduoren,zuoguobushaohaoshi,danshilundaozijiyaoqushilexinyuanquehennanshixian,tafaxianbierenzhenbangbuleziji。

laorenyizaiyaoqiuhuijiaanjinglishi,woganjinzuzhileyigeteshudejiatinghuiyi,haizimenzaiguowaizenmebanni?neizhinengxianshangkaihui。kaihuideshihou,laorendanweifuzeguanlituixiurenyuandegongzuorenyuan、xueshengzhangdaningyelaile,zhaoguguolaorendesangebaomuquanlaile。yiqingqijianzhendeshiburongyi。danyihandeshi,yinweishichadeyuanyin,kaihuishilaorendehaizimenmeiyoulianxishang。

yinweimeiyouzhixijiashuzaichang,sheiyebukenqianzidailaorenhuijia。liangtianhoulaorenqushi。yizhidaolaorenqushizhiqian,baomuhaizaipianta:“womenhuijia,womenmashanghuijia。”woneixinzhendehennanguo,laorenjiajiuyigexinyuan——huijia。weishenmejiushimanzubuleni?!

刘寅与她的团队

 

最后的忏悔

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jiadayezhuyuandedi12tian,tagenwoshuo,tayaosile,huobuguodangtian。wozhidaotadianjierzi,wenta:“wonengbunengyongnideshoujijinierzifaduanxin?”fawantaxiangshuode,woyoujialeyiju:“ruguonixiangjiannibabazuihouyimian,qingnijinkuaiguolai。”womenbuzhidaotaerzihuibuhuihuihua,dengdaideguochengyouxieaoren。wochumenzhenqule,dengdaozhongwuhuidaobingfang,hushizhangtebiegaoxingdishuo,jiadayedeerxifuxialebanjiuguolai。zhenshicangtianbufukuxinren。wogaosujiadayedeshihou,tadeshenqingmashangjiubuyiyangle,xianghuanlegeren。

dengerxifudaolaihou,tajiwomenjiangle13nianqianlaoyeziyulaobanlihun,nazoujialiquanbuxianjinbingduanjuelefuziguanxi,zhihouzaiwuwanglai。woduijiadayedeerxifushuo:“laoyezifeichangxiangnianerzihelaoban,tashuoruguonengjianerziyimian,zheibeizijiukeyifanpianla。”jiadayedeerxifushuo:“tamenfuzidemaoduntaishen,hennanhuajie。wozheijitiantiantianhetashuo,tajianjuebulai,haiduiwofapiqi。”

wogenjiadayedeerxifugoutong,shuowojichusangeliyou,xiwangerzilaikankanta。diyige,buguantaduitabayouduodayuanhen,xiwangtazaitabahuozhedeshihounengbazheiyuanqisachulai,erbushidaiyibeizi;dierge,wobuxiwangdengtadaowannian,huixiangqijintiandeshiqinghouhui,tayinggaijizijidehaizizuoyigehaobangyang;disange,ruguolaotouhaiyoushenmecaichanfangmiandewenti,buguantashiyouqianhaishifuzhai,xiwangtazaihuodeshihougennimenjiangqingchu,zheiyangchuliqilaiyaofangbiandeduo。

benlaizheixieshiqingdoushibingrendejiawushi,womenyihurenyuancanyushenlebingbuheshi,keshiruguobubajiadayedexinjiejiekai,jiadayeshibuhuizoudexinande。anningliaohuzhongyoutaiduodeshiqingbushikaoyiliaoshouduannenggoujiejuede。anningliaohusuotichangde“quanren、quanjia、quancheng、quandui”siquanzhaogu,yetixianyixueshiyouwenduderenwenguanhuai,shianningliaohudezhongyaozuchengbufen。

dengdaodiertianzhongwu11dianduo,jiadayedeerzilaile!tashiyige50duosuidehanhouzhongnianren。tachongwozuoleyigeyi,wohaileli。wojiaotajiashifu。jiashifushuo:“laotoudezuiniesantianshuobuwan。”woshuo:“jintianzhenshitaixiexienile,ninengguolaiwozhendefeichangxiexieni。qitashiqingwandianshuo,womenxianqukankanlaoren。”jiashifuzoudaochuangqian,lazhelaoyezideshoujiaoleyisheng“ba”。jiadayemomohuhuzhongmanmanzhuanguoshenlai,zhengyankanleyixia,yiweishizuomengni。jiadayejiandaoerzi,ai,benlaihenhunbulindeyigelaotouer,zhendeshiqiqiaiaidikulewufenzhong,yishoumozhezijideerduo,yishouwuzhexiongkou,shuobuchuhua。womenganjinjitashetouxiasaileliangkesuxiaojiuxinwan,patataijidong。

jiadayeyizhizaiwenerzi:“nimazhidaonilaikanwolema?”qishitalaobanlianggeyueqianjiuqushile,erzimeiyougaosuta。

congbingfangchulai,jiashifugenwoshuo,tadeshoujihaozaojiuyinggaihuandiao,zhisuoyiliulezheishijinian,“jiudengzhezuihouyitian,kanshihuozangchanghaishipaichusuojiwodadianhua,jiaowoqushoushi”。tayeyizhiliuzhefuqinlijiashixiejitadezhitiao——“shengbushanyang,sibusongzhong”。jiashifugenwoshuo:“ruguobushiyinweizhurenhehushizhang,wojintianshibuhuilaide,wobulaiduibuqinimen。tashenglewo,wojitasongzhong,zheijiushiyuan。ninfangxin,houmiandeshiwohuifuzede。”wogentashuo,buyaozhishiyuanhenniba,tanianqingshizaoyulemingyundebugong,yeshigebeijurenwu。

jiashifumeitiankanwomenfadexinxi,xinqinghenfuza,yebuxiangxinxianzaihaiyouyihurenyuanhuiguanzheiyangdeshi。suoyiwomenzuoanningliaohuderenyeyouchengjiugan,bingbuwanquanzhiyoubeishanghetongku。zuowomenzheigegongzuoderenkeyubukeqiu,yigerennengbunengshibietarendelingxingtongku,huoxuyeshizhongtianfen。anningliaohuyuxinlijiankang、gerenchengxin、falvyuanzhu、binzangfuwudeguanxiyeshifeichangmiqiede,zheigexingyehaiyouhenduogongzuotixixuyaodajian。youshihouwoyegentongshijiang,womenzuodehenduoshiqing,doubushiyishenghushigaizuode,danshianningliaohubawomendezhizewaiyankuodale。

jiashifutanfanghou,youguole11tian,jiadayequshile。qushiqianneijitianwomengentaliaotian,wentayoushenmexinyuan,xiwangchuanshenmeyangdeyifulikai,tahuidashuo“suibianle,wusuoweile”。erzilaiguo,tadexinyuanyile,manzule!tagenerzijianmianshiyetidao:“wozheiyibeiziduibuqinima,tagenzhewo,meiyouguoguoyitian分分彩网。”duiyuyigefeichangzisiderenlaishuo,linzhongqiantachanhuile,yishidaozijideguocuo,yesuanburongyi。

jiadayequshihou,jiashifubafuqindeguhuizangzailetayeyedeshenbian,bingshuofuleqinqimen,tongyitababayutamamahezang。zheiduijiadayelaishuo,yeshigeyuanmanjiejule。

既然死亡不可避免

qianduanshijian,yigelaorenzaihewoliaodaosiwangshishuo:yigerenqushi,yousanzhongyiyishangdexiaoshi:diyigeshiroutishangdexiaoshi;diergeshishehuiguanxidexiaoshi,biruyigerendezuzhiguanxi、shebaozheixiedexiaoshi;disangeshijiyidexiaoshi。yigerenshuohuadeshengyin、xiaosheng,huixiaoshi。wonenggoutanranmianduisiwang,danxiwangzisunmenbuyaotaikuaiwangjiwo。wojuedelaorenzongjiedetaidaoweile。

weishenmehuiyouzheimeyiduantanhuani?yinweilaorenjiadelianggeerzi,burenxinyufuqinzuozheiyangguanyusiwangdeduihua。lianggeerzifeichangxiaoshun,doushisiwushisuiderenle,xiaoerziweilezhaoguhuanaidemama,haiciqulegongzuo。daidaofuqinchachuaizhengwanqi,lianggeerzixinlihenbengkui,juedewufaxiangfuqintiaoming,yejuedefuqinchengshoubuleaizhengwanqideshishi。

suoyiwochengdanletanhuade“renwu”。wojiechuxialai,juedelaorenjiafeichangkaiming。womenyudaobushaojiashu,bugaosubingrenshiqing,yizaishuobingrenhuibengkui,danshishishishang,yigerenmianduisiwangshi,wangwangbijiashuyujideyaojianqiangdeduo。

wobalaorendehuazhuandajitadelianggeerzi,jianyitamenbalaorendezhaopianzuochengshipinheji,rangtazhidao,jiyihuibaoliu。lianggeerzixiaoshun,henbuyuanyitanlunfuqinjijiangliqudeshi。tamenduilaorenzhaogudehenhao,xiongdiliangjiushiputongdegongxinjieceng,keshijinzhijinxiao,meitiandoulaikanwangfuqin。

laorenhenhuoda,tazhidaozijibujiujianglishi,tashizheiyanggenwomenshuode:“diyi,xiwangwobushitongkudizou;dier,ruguowozoule,jialijiumeiyoufudanle;disan,keyijiguojiajieshengziyuan。”yiwei80duosuilaorendejuewu,rangwogandong。meigerenduisiwangdekanfabutong,danmeigerenzuihoudexinyuan,doudashangletachengzhangdeshidailuoyin。yigerennianqingshishoudaodejiaoyu,yingxiangtayibeizi,siwangmianqianyeshizheiyang。

womenzheilihaiyouyiduizhishifenzi,yeshi80suizuoyoudelaoren。liangrenzaixinhuashegongzuolehenduonian,zaonianshixuexiaoyuzhongdedaxuesheng。zhangfudaoleaizhengwanqi,qizizongshirangtajianqiang,laotaitaishuo:“nikeshibuershenweike,niyaojianqiang,laotongshimenlaidianhuadourangwozhuangaoni——yaozhanshengjibing,yaohuozhe。”laoxianshengshuo:“zheiyangtuozhetaitongkule,wobuyaojianqiang,raolewoba,fangwozouba。”anzhaowomendebanfa,wozhaojizhuguanyisheng、hushihehuanzhedelaoban、nveryikuaizaichuangpangkailegejiatinghuiyi,bingrenbiaodaletaxiwangjinkuaijieshutongkudeyuanwang。wogenlaorenjiashuo:“zanmenbuquzhudongjieshushengming,danyebuquyanhuanta,zheigeguochengwomenjinliangrangnibuganjuetongku,xingma?”yijiarenhenkuaidachengyizhi,tongyiguxizhiliao。

liangtianhoujiudaolelaoxianshengmiliuzhiji,talazhelaotaitaideshou,shuoleyijuwaiyu。laotaitaihoulaigaosuwo,laotouerzuihouyongxibanyayuduitashuo“woaini”。laotaitaiyibeizidoumaiyuanlaotouerbulangman,zheizuihoudegaobai,shixiangdanglangmanle。

neitianjiatinghuiyihou,laoliangkouguanzhemenshanglianglehenjiu,zuihoujuedinglaotaitaijinhougenzheshanghaidedidimeimeiyiqishenghuo。laoxianshengyiqushi,shanghaideqinrenguolaijielaotaitai,tajiugenzhezoule。zheishiduisiwangheshenghuodoukandefeichangtongtoudeyiduilaoren,wojuedetamenshixingfude。

anningliaohuyejiaolinzhongguanhuai,shibangzhurenmenzouguorenshengzuihouyiduanludeyizhongfangfa。anningliaohurenshibanxingzhe,ruhebangzhurenmen“zhihuidaobian”,yaoqiuwomenbuduanditansuohejianxing。zuoanningliaohushiyijianburongyideshiqing。zheijianshiqingbuzenmezhengqian,haixuyaotourudaliangdejingliheqinggan,danwojuedezheixianggongzuohenyouyiyihechengjiugan,suiranhenduorenbulijie。haodeanningliaohu,nenggoushiwomenfahuileisizhuchanshidezuoyong,bangzhubingrenanxindijinrulingyigeshijie。


1.benzhanzunxunxingyeguifan,renhezhuanzaidegaojiandouhuimingquebiaozhuzuozhehelaiyuan;2.benzhandeyuanchuangwenzhang,qingzhuanzaishiwubizhumingwenzhangzuozhehelaiyuan,buzunzhongyuanchuangdexingweiwomenjiangzhuijiuzeren;3.zuozhetougaokenenghuijingwomenbianjixiugaihuobuchong。

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